Tooth dilemma!

~Chameleon~

I saw the emergency dentist on Monday, having suffered a weekend of excruciating pain, and the outcome is that the tooth will have to come out.

I wouldn't mind so much but it's in a prominent place and the gap will show when I open my mouth

The tooth in question is upper left #5 (assuming #1 is first incisor) but it's in the position of #4 as this tooth was removed years ago due to overcrowded teeth.

The dentist did offer RCT when I said I didn't really want the tooth out but due to previous bad experiences there is no way I can undergo this without sedation. If I choose to go private it will cost around £600 but unfortunately this isn't something I can afford right now.

I've just completed a 5 day course of antibiotics (amoxycillin and metronidazole) but I'm still experiencing the same level of pain when I eat/drink anything cold.

I really don't know what to do about it and was only expecting to need a simple filling when I went in there. I was only at the dentists 3 weeks ago having an extraction of a back molar that had completely broken down to the point it was only the roots that needed removing. This was a follow-up to my 6mthly check-up so I'm puzzled as to why she didn't pick up on the problem then as I'd told her I was having problems with the tooth

I have an appt booked next week for the extraction but I'm seriously considering cancelling it as I really don't want to lose this tooth. But then if it's going to continue causing me pain ... I really don't know what to do.

Is there any option of having RCT and sedation on NHS? I know my own dentist won't do this, and having had the opportunity to see the private side of the practice at my emergency appt (boy, how the other half live!) I can understand why they charge so much.

As an aside, and referring back to the extraction I had 3 weeks ago, how long is it supposed to take to heal over? I still have a rather large cavity that bleeds every time I brush my teeth but as far as I can tell there is no infection, and I make sure to remove any food trapped in it, and the gums are pink but it's just not healing

alison999

Im not a dentist so can't say much, except that if you leave it WILL get worse and then, what if you can't get a appointment? Have you spoken to your dentist about the gap that it would leave? If not, maybe use your appontment ime next week to discuss what options you have about filling this gap?

~Chameleon~

If I want to discuss options I need to book a separate appt which will cost £30 as they've only allocated a 15 min appt for the extraction.

I'm normally an NHS patient at this practice but I saw the private dentist for the emergency appt last week. I don't think I can get the NHS dentist to treat me now the other one has become involved with this

alison999

~Chameleon~ wrote: »

If I want to discuss options I need to book a separate appt which will cost £30 as they've only allocated a 15 min appt for the extraction.

I'm normally an NHS patient at this practice but I saw the private dentist for the emergency appt last week. I don't think I can get the NHS dentist to treat me now the other one has become involved with this

i would of thought the emergency appointment was just a one off, and if i were the patient id expect to be booked back in with my usual dentist for any further treatment, unless you requested to see the private dentist?

~Chameleon~

I didn't request to see him for further treatment but I overheard the receptionist asking the dental nurse whether the appt needed to be booked with him and she said yes

I don't know whether he also does NHS work, although having seen his hi-tec room, which is worlds apart from the room next door that I usually use, then I would doubt it.

tirednewdad

~Chameleon~ wrote: »

I didn't request to see him for further treatment but I overheard the receptionist asking the dental nurse whether the appt needed to be booked with him and she said yes

I don't know whether he also does NHS work, although having seen his hi-tec room, which is worlds apart from the room next door that I usually use, then I would doubt it.

Hello Chameleon,

Alison is correct- if you leave it, it will only get worse and could be followed by facail swelling. You need to get treatment on this tooth!

Obviously different practices have there own policy, but seeing as they saw you for an emergancy treatment- ?Privately i assume?, they just have to see you for the emergancy appointment. You are not at liberty to have the finished treatment with the emergancy dentist.

As for your last dentist missing your problem- it does happen. Unfortunately as they were an NHS dentist, they are working under a lot of strain and only liable to complete any treatment that was discovered during the exam appointment. A private dentist would probably have been more likely to take a xray when you had pain.- Its a bad system blame the goverment.

Sedation is available on the NHS- You can be reffered, or your own dentist may well be comfortable enough to prescribe you some diazepam before the appointment- again this would be dependant on your Health and the dentist.

tirednewdad

As an aside, and referring back to the extraction I had 3 weeks ago, how long is it supposed to take to heal over? I still have a rather large cavity that bleeds every time I brush my teeth but as far as I can tell there is no infection, and I make sure to remove any food trapped in it, and the gums are pink but it's just not healing [/quote]

A RCT is available on the NHS, and your NHS dentist will have the skills and the training to perform the task. They have to offer you the option of a NHS RCT either with them or via refferal (providing the tooth is savable). They also have a duty to you as a patient you provide pain relief for you, if there is a waiting list for this treatment to be carried out.
Please note a RCT is not always 100% successfull.

Typically a socket will take 28 days to heal and up to 1 year before the bone remodels itself. providing you have no pain or bad taste. My advice is saltwater mouthwash and to just wait. You can also ask your dentist when you see them for the appointment about how the socket is healing.

~Chameleon~

Yes, it was the private dentist I saw for the emergency appt. He did say they could do RCT (on NHS) but I can't have this done without sedation and unfortunately that option isn't available on NHS, hence the £600 cost for private treatment.

The sedation alone is ~£200 which I might have been able to scrape together if there was an option to do private and NHS together but I don't think this is possible unfortunately.

It's just so frustrating knowing that due to this new system I'm going to have to lose a tooth which could otherwise be saved

tirednewdad

~Chameleon~ wrote: »

Yes, it was the private dentist I saw for the emergency appt. He did say they could do RCT (on NHS) but I can't have this done without sedation and unfortunately that option isn't available on NHS, hence the £600 cost for private treatment.

The sedation alone is ~£200 which I might have been able to scrape together if there was an option to do private and NHS together but I don't think this is possible unfortunately.

It's just so frustrating knowing that due to this new system I'm going to have to lose a tooth which could otherwise be saved

Sedation is available on the NHS- either through refferal or as stated, the NHS dentist can give you oral Diazepam (providing you are healthy). That is still an NHS treatment. You are unlikely, however to have the intravenous sedation as an NHS option.
Perhaps you could ring up the NHS first to discuss whether they would consider prescribing the Diazepam, and whether they feel you are able to undergo the RCT under the oral diazepam instead of the IV diazepam?

jinxsi

root canal treatment has a reputation it really does not deserve. Most root treatments are done on dead teeth and hence are totally painless and could even be done without an injection. Its just that some involve taking out a live nerve and this can be painful (I had it done at college and I nearly fainted i can tell you) This is where the bad reputation comes from. If this tooth is dead then get it root filled and dont worry about getting sedation.
jinxsi

~Chameleon~

The problem is I don't think the tooth is dead as this is the first time I've really had any problems with it and is still quite painful, plus I have a niggling doubt that the problems may lie with the tooth next to it, which has been heavily filled in the past. The outer edge of this tooth broke away some time ago and has recently had a lump of white something-or-other put over it to try disguise the horrible black filling. In fact when I looked at the x-ray taken at the emergency appt it looked like the decay/abscess was at the root of this tooth and not the one that has been designated for RCT/extraction.

Now I'm not a dentist so obviously have to trust what they say but I do know how to read x-rays so can only draw my own conclusions from what I saw.

I have cancelled the appt for the extraction tomorrow as I'm not at all happy with this decision and I shall try to find another dentist for a) a second opinion, and b) one who can perform IV sedation on the NHS.

The tooth is still troubling me somewhat with a low level of pain despite completing a double course of antibiotics so I know it needs attending asap so hope I can find someone to do the necessary work.